High deductible issues

In this article I will discuss the impact that federal or state health care policies are having on consumer costs. I have some personal experience with this. Prior to my marriage I had my own personal health insurance that I paid for out of pocket due to the fact that the insurance my company had was even more expensive. With that being said, my deductible was very high. I became pregnant prior to our marriage so a few of my prenatal appointments were under my insurance. With that, I had to pay my deductible first, before most things were covered. I am still almost two years later paying off a hospital bill from an ultrasound I had prior to being on my husband’s insurance. My husband is a federal employee, he works for the government and the insurance is absolutely different. There is no deductible to meet and I do not have to pay for anything for this pregnancy and the remainder of the last pregnancy. That was just my personal experience.

Patients are finding that their healthcare costs are rising and there are no short-term solutions in sight. With the changes in out-of-pocket responsibility, many consumers are unable to keep up with their medical bills (Peter Cunningham, 2016) a lot of times individuals come to find that the cost of the care they receive at a hospital is forever increasing. Out-of-pocket costs and things such as deductibles, co-pays, etc. have gone up so high that it is very unaffordable for most. I understand how a company would think that having a higher deductible would incentivize individuals to be healthier however that is not always the case. What about the individuals that are just not healthy in general due to a genetic disease or a freak accident and so on. It’s not fair to those people that their deductible is so high that they can’t even be comfortable going to a doctor. For the 60 percent of Americans living with at least one chronic condition, high deductibles present precarious financial conditions that recur every January 1. (Kenneth E. Thorpe Kimberly Calder Anna Hyde Laura E. Weidner, 2019) It is unfortunate that that is the case for those individuals with preexisting or chronic illnesses. That is one of the reasons why I believe that having high deductibles is not the sole solution to making individuals be healthier. Some individuals can’t help what illness they have no matter how healthy they are.

High deductible health plans pros are: premiums are typically lower than with POS or PPO plans, networks are not necessarily narrowed, as with HMOs, people who rarely use their health benefits may save money, if you are not on expensive medications, your monthly bills may be lower, out-of-pocket expenses are not the market rate, but the negotiated rate between the healthcare provider and insurance company, and policyholders can open a HAS, which never expires to help cover out-of-pocket expenses. (Rook)







References

Lori. (n.d.). Rising Healthcare Spending Takes Its Toll on Consumers. MiraMed. https://www.miramedgs.com/web/57-focus/past-issues/spring-2017/663-rising-healthcare-spending-takes-its-toll-on-consumers

Kenneth E. Thorpe Kimberly Calder Anna Hyde Laura E. Weidner. (2019, April 22). The Challenges Of High-Deductible Plans For Chronically Ill People: Health Affairs Blog. Health Affairs. https://www.healthaffairs.org/do/10.1377/hblog20190416.47741/full/

Rook, D. (n.d.). The Pros and Cons of High Deductible Health Plans (HDHPs). JP Griffin Group | Employee Benefits Broker. https://www.griffinbenefits.com/blog/pros-and-cons-high-deductible-health-plans-hdhps